南非维持生命疗法的局限性
Charles Feldman1, Gavin M Joynt2, Spyros D Mentzelopoulos3
1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Journal of critical care
|March 30, 2024
概括
生命维持疗法 (LLST) 的限制在南非ICU中很常见. 暂停治疗比停止治疗更频繁,但两者都比全球更少.
科学领域:
- 密集护理医学 密集护理医学
- 生物伦理学生物伦理学
- 全球健康 全球健康
背景情况:
- 生命维持疗法 (LLST) 的限制在重症监护病房 (ICU) 普遍存在.
- 关于南非 (南非) 的生命终端 (EOL) 护理和LLST实践的数据有限.
研究的目的:
- 评估南非ICU中的LLST实践.
- 将SA的EOL护理和LLST与国际实践进行比较.
主要方法:
- 利用了来自前性,国际,多中心,观察性Ethicus-2研究的数据.
- 将南非的LLST实践与全球其他国家的LLST实践进行了比较.
主要成果:
- 在SA中,LLST是常见的;停止治疗比停止治疗更频繁.
- 与许多其他国家相比,在SA中撤销和保留治疗的频率较低.
- 心肺复苏 (CPR) 失败在南非比其他地方更常见;没有患者有预先指令.
- 在SA中LLST的主要原因包括生活质量差,多系统器官衰竭和对最大治疗的不响应.
- EOL决策优先考虑医疗实践和患者的最佳利益,很少考虑ICU床位的可用性.
结论:
- 暂停治疗比停止治疗在南非和全球更频繁.
- 暂停和取消治疗在SA中的频率明显低于全球平均水平.
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